Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2018
Evaluation of a method for isocapnic hyperventilation: a clinical pilot trial.
Isocapnic hyperventilation (IHV) is a method that shortens time to extubation after inhalation anaesthesia using hyperventilation (HV) without lowering airway CO2 . In a clinical trial on patients undergoing long-duration sevoflurane anaesthesia for major ear-nose-throat (ENT) surgery, we evaluated the utility of a technique for CO2 delivery (DCO2 ) to the inspiratory limb of a closed breathing circuit, during HV, to achieve isocapnia. ⋯ In this cohort of patients, a DCO2 nomogram for IHV was validated. The patients were safely extubated shortly after discontinuing long-term sevoflurane anaesthesia. Perioperatively, there were no adverse effects on arterial blood gases or post-operative cognition. This technique for IHV can potentially be used to decrease emergence time from inhalation anaesthesia.
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Acta Anaesthesiol Scand · Feb 2018
Validating performance of TRISS, TARN and NORMIT survival prediction models in a Norwegian trauma population.
Anatomic injury, physiological derangement, age, injury mechanism and pre-injury comorbidity are well-founded predictors of trauma outcome. Statistical prediction models may have poorer discrimination, calibration and accuracy when applied in new locations. We aimed to compare the TRISS, TARN and NORMIT survival prediction models in a Norwegian trauma population. ⋯ In a Norwegian trauma population, the updated Norwegian survival prediction model in trauma (NORMIT 2) performed better than well-established British and US alternatives. External validation of these three models in other Nordic populations is warranted.
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Acta Anaesthesiol Scand · Feb 2018
Abdominal girth and dorso-sacral distance can be used to estimate lumbosacral cerebral fluid volume.
Patients' abdominal girth and vertebral column length are highly correlated with the spread of local anaesthetics after spinal anaesthesia. Lumbosacral cerebrospinal fluid volume is the primary determinant for spinal spread. Thus, we attempted to verify the hypothesis that abdominal girth and dorso-sacral distance are correlated with lumbosacral cerebrospinal fluid volume. ⋯ Multiple regression analysis revealed that abdominal girth and dorso-sacral distance were correlated with lumbosacral cerebrospinal fluid volume. Smaller abdominal girths and larger dorso-sacral distances predict larger lumbosacral cerebrospinal fluid volume.